An In Vitro Comparrison of Marginal Microleakage of ART and Conventional Glass Ionomer Restorations in Extracted Permanent Molars

Resident: Adam J. Bottrill
Date: 15DEC10
Region: Providence
Article title: An In Vitro Comparrison of Marginal Microleakage of ART (Alternative Restorative Treatment) and Conventional Glass Ionomer Restorations in Extracted Permanent Molars
Author(s): Wadenya, Rose BDS, MS, DMD et al
Journal: Pediatric Dentistry
Page #s: 303-307
Date: V29/No4 Jul/Aug 07
Major topic: Microleakage, ART, Margins, Glass Ionomer
Minor topic(s): NA
Type of Article: In vitro comparison
Main Purpose: The objective of this study was to compare the marginal leakage of cervical restorations made using Alternative Restorative Treatment (ART) and conventional glass ionomer restorations.

Key points in the article discussion:

I. General:

A. ART, formerly "Atraumatic Restorative Treatment", was introduced to assist in the need to prevent progression of dental caries in countries where conventional dental care was not available... Tanzania.

B. AAPD recognizes ART as useful and beneficial for:
1. Young pts
2. Uncooperative pts
3. Special needs pts
4. Situations where traditional cavity preparation and restoration is not possible

C. Glass ionomer cements:
1. Fl release
2. Low shrinkage
3. Pulpal biocompatability

II. Methods:

A. 16 permanent max and mand 1st molars extracted for perio reasons with cl V caries... ART used.

B. 29 noncarious extracted molars with cl V preparations using high speed handpiece.

C. All teeth restored with Glass Ionomer cement (GIC).

D. Thermally stressed for 300 cycles and stained with methylene blue... JUST LIKE A REAL
MOUTH!

E. Sectioned and evaluated for microleakage.

III. Results:

A. No significant difference between the ART and conventional GIC restorations.

IV. Conclustions:

A. ART with GIC shows comparable marginal leakage to conventionally restored teeth.

B. For conventional restorations, more leakage is higher at the dentinal margins when compared to the enamel margins.

Assessment of article: I believe I've already explained my "raised eyebrow" opinion of some in vitro studies... this is no different for me. ALSO... I would ave appreciated a primary tooth, occlusal surface ART study more than this PERMANENT tooth, Cl V study... huh?

Effect of Preparation technique, fissure morphology, and Material Characteristics on the In Vitro Margin Permeability and Penetrability of Pit and Fis

Department of Pediatric Dentistry
Lutheran Medical Center

Resident’s Name: Craig Elice Date: 3/6/2009
Article title: Effect of Preparation Technique, Fissure Morphology, and Material Characteristics on the In Vitro Marginal Permeability of Pit and Fissure Sealants
Author(s): Selecman JB, Owens BM, Johnson WW.
Journal: Pediatric Dentisty
Volume (number): 29:308-14
Date: July, August 2007
Major topic: Compare 5 different sealants for permeability and penetration
Type of Article: Research article
Main Purpose: This in vitro study evaluated the effect of preparation techniques, fissure morphology and material characteristics on the marginal permeability and penetrability of 5 different pit and fissure sealants
Materials and Methods: 100 extracted permanent molars assigned to ten groups consisting of 5 sealants Aegis , Conseal f, Admira-seal,Triage, and Delton opaque divided into two groups, pumice prophy and acid etch (PP) vs air abrasion (AA). Microleakage was assessed by thermocycling for 1000 cycles protecting the root apex with utility wax and nail varnish and immersing in methylene blue dye for 24 hours and preparing for microscopic evaluation to assess dye penetration, sealant penetrability, and fissure morphology.
Findings: Leakage: The Aegis PP group had significantly lower leakage that most sealants while no leakage was measured in 44% of the specimens and 18% had minimal leakage. Admira-seal had 90% with some leakage and 70% with the maximum leakage. Penetrability: Delton PP had the highest penetrability while Aegis PP had the lowest penetrability. Fissure type analysis: no significant differences between fissue types and microleakage and penetrability although flatter grooves tended to have better penetrability. Observations made by the authors include the fact that Triage glass ionomer sealant showed cracking and exhibited the highest microleakage and poorest retention rates. Interestingly Triage and Aegis had higher surface absorption of methylene blue but did not indicate a relationship with microleakage per se, only esthetics. In most cases, surface preparation did not affect microleakage or penetrability. However the results indicate that air abrasion is too aggressive in conditioning enamel for sealant bonding. There was no correlation between microleakage and penetrability of the sealants.
Key points/Summary : Aegis sealants show the least microleakage and inferior penetrability. Delton and Triage have superior penetrability. Fissure morphology significantly influences selant penetrability but no correlation to microleakage. Flatter grooves have deeper penetrability.
Assessment of article: Fair particle. Conclusions do not offer much clinical applicability.

Microleakage at Sealant/Enamel Interface of Primary Teeth: Effect of Er:YAG Laser Ablation of Pits and Fissures

Department of Pediatric Dentistry
Lutheran Medical Center
Date: 02/27/2009
Article title: Microleakage at Sealant/Enamel Interface of Primary Teeth: Effect of Er:YAG Laser Ablation of Pits and Fissures
Author(s): Borsatto MC, et al
Journal: Journal of Dentistry for Children
Volume (number): 71:2
Month, Year: 2004
Major topic: Sealant enamel microleakage
Minor topics: etch technique and laser ablation
Type of Article: clinical study
Main Purpose: To compare microleakage of sealants using 3 etching techniques
Overview of method of research: Primary molars were split into 3 groups to have sealant placed on the occlusal surfaces. The 1st group was etched with 37% phosphoric acid, group 2 acid etch and laser preparation, and group 3 laser preparation alone.
The molars were placed in a dye solution after a round of thermal-cycling. The teeth were then sectioned and polished into .25mm strips and looked at under a microscope and analyzed with computer software for degree of dye penetration.
Findings:
Group 1 and 2 had equal levels of microleakage. Group 3, however, had almost twice the degree of microleakage.

Key points/Summary :
Sealants success depends on its ability to:
fill pits, fissures and anatomical defects
remain bonded to enamel and not allow microleakage and consequent development of caries.
Lasers have been shown to alter enamel surface anatomy--microscopically--similar to etching in both permanent and primary teeth.
It has been speculated that laser ablation could produce a similar effect to etching
All preparations experienced some degree of microleakage.
The laser and etch technique had slightly less microleakage, but it was not statistically significant.
The authors thought that although the laser “etched” the tooth surface, it was probably irregular, which might explain the leakage.
Assessment of article: Good article. I like lasers (laser-cats) and it’s good to have some articles to ground the promoters of the product.